Pulmonary sequestration

肺隔离症
  • 文章类型: Case Reports
    肺隔离症伴扭转是一种罕见的疾病。我们描述了一个七个月大的婴儿,由于扭转导致肺隔离症而过度哭泣。对比增强胸部计算机断层扫描显示右下胸部后内侧有椭圆形肿块,没有明显的全身动脉供应.质量的边缘显示出轻微的线性增强,它的内部没有加固。进行了胸腔镜节段切除术,组织学证实肺隔离症伴扭转。
    Pulmonary sequestration with torsion is a rare condition. We describe a seven-month-old baby presenting excessive crying for pulmonary sequestration with torsion. Contrast-enhanced chest computed tomography demonstrated an oval-shaped mass in the posteromedial right lower chest, no systemic arterial supply was evident. The edge of the mass showed slight linear reinforcement, and its interior had no reinforcement. Thoracoscopic segmentectomy was carried out and histology confirmed pulmonary sequestration with torsion.
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  • 文章类型: Case Reports
    肺隔离症是罕见的先天性畸形。即使在出现反复肺炎症状的年轻人中,考虑肺隔离症也很重要,因为及时的手术干预既可行又可治愈。此外,在缺乏CT/MRI血管造影服务的健康环境中,肺隔离症易误诊为涂阴肺结核。因此,需要强烈的临床怀疑以防止患者管理不善。
    Pulmonary sequestration is uncommon congenital malformation. It is important to consider pulmonary sequestration even in young adults presenting with recurrent pneumonic symptoms because prompt surgical intervention is both feasible and curative. Moreover, in health settings lacking CT/MRI angiography service, pulmonary sequestration can be easily misdiagnosed as smear negative pulmonary tuberculosis. Therefore, strong clinical suspicion is required to prevent patient mismanagement.
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  • 文章类型: Case Reports
    钙化纤维瘤(CFT),也被称为钙化性纤维假瘤,是一种不常见的非癌性肿瘤,通常位于胃肠道。它在肺中的位置极为罕见,只有少数病例报告发表。此病例报告描述了我们在一名9岁男性偶然肺部肿块患者中的诊断方法。该肿块最初被误诊,需要多种影像学检查和干预才能获得肺部CFT的明确诊断。本文旨在通过提供计算机断层扫描和磁共振成像的详细发现,为有关肺CFT的有限信息做出贡献。
    A calcifying fibrous tumor (CFT), also known as calcifying fibrous pseudotumor, is an uncommon non-cancerous neoplasm usually located in the gastrointestinal tract. Its location in the lung is extremely rare, and only a few case reports have been published. This case report describes our diagnostic approach in a 9-year-old male patient with an incidental pulmonary mass. The mass was initially misdiagnosed, requiring multiple imaging tests and interventions to obtain the definitive diagnosis of pulmonary CFT. This paper aims to contribute to the limited information available on pulmonary CFT by presenting detailed findings from computed tomography and magnetic resonance imaging.
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  • 文章类型: Case Reports
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  • 文章类型: Case Reports
    支气管肺隔离症在成人中很少出现,并且在动脉瘤异常供血动脉中的频率较低。支气管肺隔离症的治疗通常包括血管结扎的肺切除术;然而,动脉瘤性疾病增加了术中和术后出血的风险,通常需要更广泛的手术来控制血管.一名39岁的女性患者,有腹部手术史,突然出现上腹部和背部疼痛。计算机断层扫描显示动脉瘤异常肺动脉起源于腹主动脉,邻近腹腔动脉,在右下肺叶提供叶内肺隔离症。她也有胆石症的证据,混淆症状相关性。她接受了微创混合方法的治疗,其中涉及延迟胸腔镜肺切除术前的血管内动脉栓塞。这是一种安全有效的方法,可降低术中出血的风险,同时安全地实现动脉瘤疾病附近的血管控制。
    Bronchopulmonary sequestration presents rarely in adults and less frequently with an aneurysmal aberrant feeding artery. Treatment of bronchopulmonary sequestration generally involves lung resection with vascular ligation; however, aneurysmal disease increases the risk of intra- and postoperative hemorrhage and often necessitates more extensive surgery for vascular control. A 39-year-old female patient with a history of prior abdominal surgery presented with sudden onset epigastric and back pain. Computed tomography demonstrated an aneurysmal aberrant pulmonary artery originating from the abdominal aorta, adjacent to the celiac artery, supplying an intralobar pulmonary sequestration in the inferior right lower lung lobe. She also had evidence of cholelithiasis, with confusing symptom correlation. She was treated with a minimally invasive hybrid approach, which involved endovascular arterial embolization prior to delayed thoracoscopic lung resection. This is a safe and effective approach that reduces the risk of intraoperative bleeding while safely achieving vascular control proximal to the aneurysmal disease.
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  • 文章类型: Journal Article
    背景:弯刀综合征是一种罕见的先天性心脏病(CHD),其特征是右肺异常肺静脉引流到下腔静脉。我们描述了演示文稿,诊断,10例尖刀综合征患儿的治疗管理和长期随访。
    方法:我们对来自我们机构的所有患有弯刀综合征(1996年3月至2023年7月)的儿科患者进行了回顾性观察性研究。患者接受系统评估,包括病史和家族史,胸部X光,12导联心电图,超声心动图,血管造影和/或计算机断层扫描;或磁共振血管造影。
    结果:包括10例弯刀综合征患者。诊断时的中位年龄为10.4[0.1-150.2]个月,中位随访时间为7.7[1.3-15.3]年。八名患者出现主动脉肺侧支动脉栓塞。两名患者与下腔静脉和左心房有双重连接;下腔静脉连接的栓塞仅在其中之一中可行。没有患者接受弯刀静脉手术。三名患者接受了CHD的手术矫正。随访期间无与弯刀综合征相关的死亡病例。
    结论:所有患有弯刀综合征的患者都需要及时的心血管评估和随访。我们的研究表明,保守的方法与主肺侧支动脉栓塞,当发现左心房双重引流时,弯刀静脉栓塞,在有弯刀综合征的患者中,伴随合并CHD的矫正可能取得良好的效果,以便在有临床或血液动力学指示的情况下,将肺静脉异常回流的手术矫正推迟到年龄较大的患者.需要进行更长期随访和更大样本量的进一步研究,以更有效地确定治疗策略。
    BACKGROUND: Scimitar syndrome is a rare form of congenital heart disease (CHD) characterized by anomalous pulmonary venous drainage of the right lung to the inferior vena cava. We describe the presentation, diagnosis, therapeutic management and long-term follow-up of 10 pediatric patients with Scimitar Syndrome.
    METHODS: We performed a retrospective observational study of all pediatric patients from our institution with scimitar syndrome (March 1996-July 2023). Patients underwent systematic evaluation including medical and family history, chest x-ray, 12-lead electrocardiogram, echocardiogram, angiography and/or computed tomography; or magnetic resonance angiography.
    RESULTS: Ten patients with scimitar syndrome were included. The median age at diagnosis was 10.4 [0.1-150.2] months and the median follow-up time was 7.7 [1.3-15.3] years. Eight patients presented with aortopulmonary collateral arteries which were embolized. Two patients had dual connections to the inferior vena cava and left atrium; embolization of the inferior vena cava connection was only feasible in one of them. No patients underwent surgery of the scimitar vein. Three patients had surgical correction of CHDs. There were no deaths related to scimitar syndrome during follow-up.
    CONCLUSIONS: All patients with scimitar syndrome need prompt cardiovascular evaluation and follow-up. Our study demonstrates that a conservative approach with aortopulmonary collateral artery embolization, scimitar vein embolization when dual drainage to the left atrium is identified, along with correction of concomitant CHDs might have good results in patients with scimitar syndrome in order to postpone surgical correction of the anomalous pulmonary venous return to an older age when clinically or hemodynamically indicated. Further studies with longer-term follow-up and a larger sample size are needed to more effectively determine treatment strategy.
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  • 文章类型: Case Reports
    胸腔积液在新生儿期很少见,估计患病率为0.06%。有时可能罕见地继发于肺隔离症。除了胎儿水肿等常见疾病,先天性心脏病,先天性乳糜胸,染色体异常;在评估新生儿胸腔积液的原因时,还应考虑肺隔离症。
    Pleural effusion is rare during neonatal period with an estimated prevalence of 0.06%. It may sometimes uncommonly be secondary to pulmonary sequestration. Besides common conditions like hydrops fetalis, congenital heart disease, congenital chylothorax, chromosomal abnormalities; pulmonary sequestration should also be considered while evaluating the cause for neonatal pleural effusion.
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  • 文章类型: Journal Article
    目的:膈内肺外隔离(EPS)(ID-EPS)很少见,需要额外的手术,例如切开或将膈肌从病变处脱离以进行诊断。本研究旨在描述影像学发现并评估超声和计算机断层扫描(CT)对ID-EPS的诊断准确性。
    方法:隔膜标志,病变边缘的形状,在超声和CT上将静脉引流到腹腔内,使用Fisher精确检验比较ID-EPS和膈上EPS(AD-EPS)患者的超声病变特征。
    结果:3和9例患者被诊断为ID-EPS和AD-EPS,分别。在超声检查下,两组之间的隔膜征(ID-EPS与AD-EPS患者的存在/不存在,2/1对0/9,P=.046),超声/CT上病变边缘的形状(ID-EPS与AD-EPS患者的圆形/喙,3/0vs0/9,CT和超声均为P=.005),超声的病变特征(ID-EPS与AD-EPS患者的病变内存在/不存在囊性区域,0/3vs7/2,P=.046),CT显示引流静脉进入腹部(ID-EPSvsAD-EPS患者存在/不存在;2/1vs0/9,P=0.046)。在超声检查中,腹部未显示引流静脉,两组之间在CT上的分裂图征象的存在/不存在(ID-EPSvsAD-EPS和ID-EPS患者的存在/不存在;0/3vs0/9,P>.999;1/2vs0/9,P=.250)没有显着差异。
    结论:产后超声检查和CT检查的结合可用于预测隔膜内的EPS。
    OBJECTIVE: Extrapulmonary sequestration (EPS) within the diaphragm (ID-EPS) is rare and requires additional procedures such as incision or detachment of the diaphragm from the lesion for diagnosis. This study aimed to describe the imaging findings and evaluate the diagnostic accuracy of ultrasonography and computed tomography (CT) for ID-EPS.
    METHODS: Split diaphragm sign, shape of lesion edge, drainage vein into intra-abdomen on ultrasound and CT, and lesion characteristics on ultrasound were compared between patients with ID-EPS and with above-diaphragm EPS (AD-EPS) using Fisher\'s exact test.
    RESULTS: Three and nine patients were diagnosed with ID-EPS and AD-EPS, respectively. Significant differences were observed between the two groups in the split diaphragm sign on ultrasound (presence/absence in patients with ID-EPS vs AD-EPS, 2/1 vs 0/9, P = .046), shape of lesion edge on ultrasound/CT (round/beak in patients with ID-EPS vs AD-EPS, 3/0 vs 0/9, P = .005 on both CT and ultrasound), lesion characteristics on ultrasound (presence/absence of cystic area within lesion in patients with ID-EPS vs AD-EPS, 0/3 vs 7/2, P = .046), and the drainage vein into the abdomen on CT (presence/absence in patients with ID-EPS vs AD-EPS; 2/1 vs 0/9, P = .046). No drainage veins were visualized in the abdomen on ultrasonography and no significant differences in the presence/absence of the split-diagram sign on CT (presence/absence in patients with ID-EPS vs AD-EPS and ID-EPS; 0/3 vs 0/9, P > .999; 1/2 vs 0/9, P = .250) were observed between the two groups.
    CONCLUSIONS: A combination of postnatal ultrasonography and CT was useful in predicting EPS located within the diaphragm.
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  • 文章类型: Journal Article
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  • 文章类型: Case Reports
    肺隔离症(PS)是一种罕见的先天性异常,其特征是由异常的全身血管提供的非传染性肺组织。我们介绍了一个30岁的男性,患有球内PS,从腹腔动脉接受动脉供应,表现为大咯血.紧急稳定后,使用聚乙烯醇颗粒的血管内栓塞被成功采用.病人的症状消失了,随访证实恢复令人满意。我们的病例强调了PS的多种动脉起源以及血管内栓塞作为微创治疗的功效。PS的复杂性,它的诊断成像,并讨论了替代治疗方案,强调在管理这种罕见的先天性异常时采用量身定制的方法以获得最佳结果。
    Pulmonary sequestration (PS) is a rare congenital anomaly characterized by noncommunicative lung tissue supplied by an abnormal systemic vessel. We present a case of a 30-year-old male with intralobar PS, receiving arterial supply from the celiac artery, manifesting as massive hemoptysis. After urgent stabilization, endovascular embolization using polyvinyl alcohol particles was successfully employed. The patient\'s symptoms resolved, and follow-up confirmed satisfactory recovery. Our case underscores the diverse arterial origins of PS and the efficacy of endovascular embolization as a minimally invasive treatment. The complexity of PS, its diagnostic imaging, and alternative therapeutic options are discussed, emphasizing tailored approaches for optimal outcomes in managing this uncommon congenital anomaly.
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